A case report of hearing loss post use of hydroxychloroquine in a HIV-infected patient

Khalili, Hossein; Dastan, Farzaneh; Manshadi, Seyed Ali Dehghan

doi:10.1186/2008-2231-22-20

Cited by 16 publications

(36 citation statements)

References 17 publications

(21 reference statements)

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“…Sensorineural hearing loss was identified after hydroxychloroquine treatment in five adults and two children. The sensorineural hearing loss was found to be either reversible (25,28) or irreversible (24,29). The onset of hearing loss after hydroxychloroquine treatment varied from 1 month (25) to several years (29).…”

Section: Hydroxychloroquine Ototoxicitymentioning

confidence: 99%

Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review

Prayuenyong

Kasbekar

Baguley

2020

Front. Public Health

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At this time of the COVID-19 pandemic, potentially effective treatments are currently under urgent investigation. Benefits of chloroquine and hydroxychloroquine for the treatment of COVID-19 infection have been proposed and clinical trials are underway. Chloroquine and hydroxychloroquine, typically used for the treatment of malaria and autoimmune diseases, have been considered for off-label use in several countries. In the literature, there are reports of ototoxic effects of the drugs causing damage to the inner ear structures, which then result in hearing loss, tinnitus, and/or imbalance. This mini-review represents a summary of the findings from a systematic search regarding ototoxicity of chloroquine and hydroxychloroquine in the published literature. The characteristics of sensorineural hearing loss and/or tinnitus after chloroquine or hydroxychloroquine treatment can be temporary but reports of persistent auditory and vestibular dysfunction exist. These are not frequent, but the impact can be substantial. Additionally, abnormal cochleovestibular development in the newborn was also reported after chloroquine treatment in pregnant women. The suggested dose of chloroquine for COVID-19 infection is considerably higher than the usual dosage for malaria treatment; therefore, it is plausible that the ototoxic effects will be greater. There are potential implications from this review for survivors of COVID-19 treated with chloroquine or hydroxychloroquine. Patient reports of hearing loss, tinnitus, or imbalance should be noted. Those with troublesome hearing loss, tinnitus and/or imbalance are encouraged to be referred for hearing evaluation and interventions once they are stable. Clinical trials of chloroquine or hydroxychloroquine should also consider including audiological monitoring in the protocol.

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Section: Hydroxychloroquine Ototoxicitymentioning

confidence: 99%

Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review

Prayuenyong

Kasbekar

Baguley

2020

Front. Public Health

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“…Ototoxicity has been reported both with CQ 53 and less frequently with HCQ. 54 This ADR may induce hearing loss, tinnitus, vertigo, and disequilibrium. Accordingly, CQ/HCQ ototoxicity may mimic stroke in patients with COVID-19 infection.…”

Section: Major Neurologic Adverse Drug Reactions (Adrs)mentioning

confidence: 99%

<p>Major Neurologic Adverse Drug Reactions, Potential Drug–Drug Interactions and Pharmacokinetic Aspects of Drugs Used in COVID-19 Patients with Stroke: A Narrative Review</p>

Ghasemiyeh

Borhani‐Haghighi

Karimzadeh

et al. 2020

TCRM

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Stroke has been considered as one of the underlying diseases that increases the probability of severe infection and mortality. Meanwhile, there are ongoing reports of stroke subsequent to COVID-19 infection. In this narrative paper, we reviewed major neurologic adverse drug reactions (ADRs) and pharmacokinetics of drugs which are routinely used for COVID-19 infection and their potential drug-drug interactions (PDDIs) with common drugs used for the treatment of stroke. It is highly recommended to monitor patients on chloroquine (CQ), hydroxychloroquine (HCQ), antiviral drugs, and/or corticosteroids about initiation or progression of cardiac arrhythmias, delirium, seizure, myopathy, and/or neuropathy. In addition, PDDIs of anti-COVID-19 drugs with tissue plasminogen activator (tPA), anticoagulants, antiaggregants, statins, antihypertensive agents, and iodine-contrast agents should be considered. The most dangerous PDDIs were interaction of lopinavir/ritonavir or atazanavir with clopidogrel, prasugrel, and new oral anticoagulants (NOACs).

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“…As it was described before, the hearing loss is usually irreversible, but there are some exceptions reported in the literature. 30 Furthermore, there are reports of children with systemic erythematosus lupus who developed ototoxicity soon after the therapy with hydroxychloroquine was initialized. Lim and Tang (2011) reported an 11-year-old girl treated with hydroxychloroquine, and, 2 months later, she complained of reduced hearing in both ears.…”

Section: Discussionmentioning

confidence: 99%

“…As it was described before, the hearing loss is usually irreversible, but there are some exceptions reported in the literature. 30 …”

Section: Discussionmentioning

confidence: 99%

Chloroquine and COVID-19: Should We Care about Ototoxicity?

Monteiro

Nascimento

Brito

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Severe acute respiratory syndrome coronavirus 2 was first described in December 2019 in China leading to a Public Health Emergency of International Concern. It was named by the World Health Organization as Coronavirus Disease 2019 (COVID-19), and it garnered unprecedented attention from public health researchers around the world, and studies analyzing chloroquine and hydroxychloroquine as a possible therapy have arisen in the last 2 months. Objective To review the literature and describe updated facts about the ototoxicity of chloroquine and hydroxychloroquine, an important side effect that can be present in patients with COVID-19 treated with these drugs. Data Synthesis The most typical treatment regimen is 5 days of hydroxychloroquine at daily doses of 400 to 600 mg. There is no randomized clinical trial that can prove so far the efficacy of this medication, and few studies have evaluated adverse events potentially linked to their use in patients with COVID-19. While there is no concrete evidence on the incidence of ototoxicity using chloroquine in the short term, we need to consider that, as a pandemic disease, millions of patients with COVID-19 may receive this treatment, and ototoxicity can be a possible adverse event. Conclusion Despite the urgent global situation caused by the COVID-19, the risk of irreversible hearing loss may outweigh the unproven benefit of using hydroxychloroquine or chloroquine, especially in patients with mild forms of COVID-19, who may be cured with supportive treatment. The potential hearing loss that can be caused by these medications may advise against their use in COVID-19 patients.

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A case report of hearing loss post use of hydroxychloroquine in a HIV-infected patient

Cited by 16 publications

References 17 publications

Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review

Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review

<p>Major Neurologic Adverse Drug Reactions, Potential Drug–Drug Interactions and Pharmacokinetic Aspects of Drugs Used in COVID-19 Patients with Stroke: A Narrative Review</p>

Chloroquine and COVID-19: Should We Care about Ototoxicity?

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